In sport horses with back pain, acupuncture is one of the used complementary alternative medicine. (CAM) This report contains an overview on the pathogenesis of back pain and describes the working mechanism of acupuncture. Articles describing the effect of acupuncture on horses with chronic back pain are critically reviewed. A suggestion for a study design is included to evaluate the effect of acupuncture on the muscle activity of the longissimus dorsi muscle
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